STANDARD DATA DICTIONARY #355.91 -- IB INSURANCE CO LEVEL BILLING PROV ID FILE 3/24/25 PAGE 1
STORED IN ^IBA(355.91, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file contains one record for each provider id that an insurance company assigns to a facility for ALL billing providers at the
facility. Each record can be for an insurance company and any combination of the patient status, form type and care unit. There
must be only one record for each combination.
This file contains the id numbers for the following levels:
o Assigned by insurance company to all providers
o Assigned by insurance company, to all providers, one id for each care
unit
DD ACCESS: @
RD ACCESS:
WR ACCESS: @
DEL ACCESS: @
LAYGO ACCESS: @
AUDIT ACCESS:
IDENTIFIED BY: FORM TYPE APPLIED TO (#.04)[R], BILL CARE TYPE (#.05)[R], PROVIDER ID TYPE (#.06)[R]
CROSS
REFERENCED BY: PROVIDER ID CARE UNIT(ACARE), INSURANCE CO(B), PROVIDER ID(C)
INDEXED BY: INSURANCE CO & PROVIDER ID TYPE & INDEX VALUE CARE UNIT (AC), INSURANCE CO & INDEX VALUE CARE UNIT & FORM TYPE
APPLIED TO & BILL CARE TYPE & PROVIDER ID TYPE (AUNIQ)
355.91,.01 INSURANCE CO 0;1 POINTER TO INSURANCE COMPANY FILE (#36) (Required)
INPUT TRANSFORM: I $G(DA),$$DUP1^IBCEP1(.01,DA) K X
LAST EDITED: OCT 18, 2000
HELP-PROMPT: Enter an insurance company name.
DESCRIPTION:
This is the name of the insurance company that the id is being defined for.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 355.91^B
1)= S ^IBA(355.91,"B",$E(X,1,30),DA)=""
2)= K ^IBA(355.91,"B",$E(X,1,30),DA)
CROSS-REFERENCE: ^^TRIGGER^355.91^.1
1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^IBA(355.91,D0,0)):^(0),1:"") S X=$P(Y(1),U
,10)="" I X S X=DIV S Y(1)=$S($D(^IBA(355.91,D0,0)):^(0),1:"") S X=$P(Y(1),U,10),X=X S DIU=X K Y S
X=DIV S X="*N/A*" X ^DD(355.91,.01,1,2,1.4)
1.4)= S DIH=$G(^IBA(355.91,DIV(0),0)),DIV=X S $P(^(0),U,10)=DIV,DIH=355.91,DIG=.1 D ^DICR
2)= Q
3)= Do not delete
CREATE CONDITION)= INDEX VALUE CARE UNIT=""
CREATE VALUE)= "*N/A*"
DELETE VALUE)= NO EFFECT
FIELD)= INDEX VALUE CARE UNIT
This trigger 'seeds' a value into the key field for care unit so the value is never null, even if
the care unit is not entered.
RECORD INDEXES: AC (#121), AUNIQ (#122)
355.91,.03 PROVIDER ID CARE UNIT 0;3 POINTER TO IB INS CO PROVIDER ID CARE UNIT FILE (#355.96)
INPUT TRANSFORM: S DIC("S")="I +$G(^IBA(355.96,+Y,0))=+$G(^IBA(355.91,DA,0))" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X I
$D(X),$$DUP1^IBCEP1(.03,DA) K X
LAST EDITED: JUN 07, 2004
HELP-PROMPT: Enter the specific care unit needed to get the provider id.
DESCRIPTION: This is the generic, lowest breakdown provided for identification of the provider id. This can be
virtually any piece of data the insurance co chooses to use. The unit must be entered manually on
each bill.
*** NOT CURRENTLY USED ***
SCREEN: S DIC("S")="I +$G(^IBA(355.96,+Y,0))=+$G(^IBA(355.91,DA,0))"
EXPLANATION: Must be a valid care unit as defined for the insurance company
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: ^^TRIGGER^355.91^.1
1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S X=Y(0),X=X I X S X=DIV S Y(1)=$S($D(^IBA(355.91,D0,0))
:^(0),1:"") S X=$P(Y(1),U,10),X=X S DIU=X K Y S X=DIV S X=DIV,X=X X ^DD(355.91,.03,1,1,1.4)
1.4)= S DIH=$G(^IBA(355.91,DIV(0),0)),DIV=X S $P(^(0),U,10)=DIV,DIH=355.91,DIG=.1 D ^DICR
2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBA(355.91,D0,0)):^(0),1:"") S X=$P(Y(1),U,10),X=X
S DIU=X K Y S X=DIV S X="*N/A*" S DIH=$G(^IBA(355.91,DIV(0),0)),DIV=X S $P(^(0),U,10)=DIV,DIH=355.9
1,DIG=.1 D ^DICR
CREATE CONDITION)= INTERNAL(PROVIDER ID CARE UNIT)
CREATE VALUE)= INTERNAL(PROVIDER ID CARE UNIT)
DELETE VALUE)= "*N/A*"
FIELD)= INDEX VALUE CARE UNIT
CROSS-REFERENCE: 355.91^ACARE
1)= S ^IBA(355.91,"ACARE",$E(X,1,30),DA)=""
2)= K ^IBA(355.91,"ACARE",$E(X,1,30),DA)
3)= Do not delete
This xref allows quick access to the file by care unit.
355.91,.04 FORM TYPE APPLIED TO 0;4 SET (Required)
'0' FOR BOTH UB-04 AND CMS-1500 FORMS;
'1' FOR UB-04 FORMS ONLY;
'2' FOR CMS-1500 FORMS ONLY;
LAST EDITED: JAN 16, 2007
HELP-PROMPT: Select one or both forms that the provider id will apply to.
DESCRIPTION: This designates whether the id number is to be used for just UB-04 form types, just CMS-1500 form
types or both form types.
RECORD INDEXES: AUNIQ (#122)
355.91,.05 BILL CARE TYPE 0;5 SET (Required)
'0' FOR BOTH INPATIENT AND OUTPATIENT;
'1' FOR INPATIENT ONLY;
'2' FOR OUTPATIENT ONLY;
'3' FOR PRESCRIPTION ONLY;
INPUT TRANSFORM: I $G(DA),$$DUP1^IBCEP1(.05,DA) K X
LAST EDITED: SEP 07, 2000
HELP-PROMPT: Enter the type of care (inpatient/outpatient/Rx) that this id # will apply to.
DESCRIPTION: This designates whether the id number is to be used for just inpatient bills, just outpatient
bills, both inpatient and outpatient bills or just prescriptions.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
RECORD INDEXES: AUNIQ (#122)
355.91,.06 PROVIDER ID TYPE 0;6 POINTER TO IB PROVIDER ID # TYPE FILE (#355.97) (Required)
INPUT TRANSFORM: S DIC("S")="I $S('$P(^(0),U,2):1,1:$P(^(0),U,2)=3)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X I $D(X),$$D
UP1^IBCEP1(.06,DA) K X
LAST EDITED: OCT 18, 2000
HELP-PROMPT: Enter the type of id # being recorded.
DESCRIPTION:
This is the indicator of what type of id is being recorded.
SCREEN: S DIC("S")="I $S('$P(^(0),U,2):1,1:$P(^(0),U,2)=3)"
EXPLANATION: If limited, provider id type must be assigned by insurance co for all providers
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
RECORD INDEXES: AC (#121), AUNIQ (#122)
355.91,.07 PROVIDER ID 0;7 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>15!($L(X)<1)!'(X?1N.E!(X?1A.E)) X
LAST EDITED: MAY 07, 2001
HELP-PROMPT: Answer must be 1-15 characters in length and must begin with a number or letter.
DESCRIPTION:
This is the provider ID that will be reported for the provider id type for the insurance co
CROSS-REFERENCE: 355.91^C
1)= S ^IBA(355.91,"C",$E(X,1,30),DA)=""
2)= K ^IBA(355.91,"C",$E(X,1,30),DA)
3)= Do not delete
Lookup by provider id #
355.91,.1 INDEX VALUE CARE UNIT 0;10 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
LAST EDITED: OCT 18, 2000
HELP-PROMPT: Answer must be 1-30 characters in length.
DESCRIPTION: This field contains the value for the care unit or '*N/A*' if no care unit is selected. This is to
assure uniqueness in the records in the file even if the care unit is blank.
TECHNICAL DESCR:
Triggered on entry of the record by the .01 field to *N/A*
WRITE AUTHORITY: ^
NOTES: TRIGGERED by the INSURANCE CO field of the IB INSURANCE CO LEVEL BILLING PROV ID File
TRIGGERED by the PROVIDER ID CARE UNIT field of the IB INSURANCE CO LEVEL BILLING PROV ID File
RECORD INDEXES: AC (#121), AUNIQ (#122)
FILES POINTED TO FIELDS
IB INS CO PROVIDER ID CARE UNI
(#355.96) PROVIDER ID CARE UNIT (#.03)
IB PROVIDER ID # TYPE (#355.97) PROVIDER ID TYPE (#.06)
INSURANCE COMPANY (#36) INSURANCE CO (#.01)
File #355.91
Record Indexes:
AC (#121) RECORD REGULAR IR SORTING ONLY
Short Descr: Xref by insurance co,provider type,care unit
Set Logic: S ^IBA(355.91,"AC",X(1),X(2),$E(X(3),1,30),DA)=""
Kill Logic: K ^IBA(355.91,"AC",X(1),X(2),$E(X(3),1,30),DA)
Whole Kill: K ^IBA(355.91,"AC")
X(1): INSURANCE CO (355.91,.01) (Subscr 1) (forwards)
X(2): PROVIDER ID TYPE (355.91,.06) (Subscr 2) (forwards)
X(3): INDEX VALUE CARE UNIT (355.91,.1) (Subscr 3) (Len 30) (forwards)
AUNIQ (#122) RECORD MUMPS IR SORTING ONLY
Short Descr: Xref by ins co,care unit,form type,pt stat,prov type
Description: This cross reference provides an index to insure that each record in this file has a unique combination of
insurance company, form type, patient status and provider id type.
Set Logic: S ^IBA(355.91,"AUNIQ",X(1),$S(X(2):$E(X(2),1,30),1:"*N/A*"),X(3),X(4),X(5),DA)=""
Kill Logic: K ^IBA(355.91,"AUNIQ",X(1),$S(X(2):$E(X(2),1,30),1:"*N/A*"),X(3),X(4),X(5),DA)
Whole Kill: K ^IBA(355.91,"AUNIQ")
X(1): INSURANCE CO (355.91,.01) (Subscr 1) (forwards)
X(2): INDEX VALUE CARE UNIT (355.91,.1) (Subscr 2) (Len 30) (forwards)
X(3): FORM TYPE APPLIED TO (355.91,.04) (Subscr 3) (forwards)
X(4): BILL CARE TYPE (355.91,.05) (Subscr 4) (forwards)
X(5): PROVIDER ID TYPE (355.91,.06) (Subscr 5) (forwards)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):